3.0T定量动态对比增强MRI对中央区前列腺癌的应用价值研究

摘要

目的：研究3．0TMRI动态对比增强定量参数对中央区前列腺癌的诊断价值。方法回顾性分析采用3．0T M RI扫描仪进行前列腺动态对比增强M RI检查的39例前列腺中央区病变患者资料，患者均在M RI检查后1周内经手术或穿刺病理证实诊断。分别测量中央区病灶与非病灶区的定量血流动力学参数，包括容量转移常数（volume transfer constant ，Ktrans ）和血管外细胞外间隙容积比（extravascular extracellular space distribute volume per unit tissue volume ， Ve ）。采用单因素方差分析比较中央区前列腺癌、良性增生与非病灶区的组间差异，受试者特性曲线（receiVe r operating characteristic curVe ，ROC）分析定量参数诊断中央区前列腺癌与良性增生的敏感度、特异度。结果中央区前列腺癌（n＝17）的Ktrans和Ve 均值分别为（13．09±2．55）min-1和（4．57±0．81）；良性增生（n＝22）的Ktrans和Ve 均值分别为（8．79±1．15）min-1和（5．14±1．02）；非病灶区（n＝29）的Ktrans和Ve 均值分别为（5．34±0．98）min-1和（4．23±0．78）。中央区前列腺癌、良性增生与非病灶区组间Ktrans的差异有统计学意义（ F值为4．271，P值＜0．05），Ve 的差异无统计学意义（ F值为0．553，P值＞0．05）。以最大约登指数为最佳诊断切点值，Ktrans和Ve 判断中央区前列腺癌与良性增生的的敏感度分别为73．4％和54．3％；特异度分别为82．7％和47．9％。结论3．0T M RI动态对比增强定量血流动力学参数Ktrans对中央区前列腺癌与良性增生的鉴别诊断具有很高的诊断价值，但Ve 没有太大意义。%Objective To evaluate the value of quantitative parameters of Dynamic Contrast-Enhanced MRI (DCE MRI) in the diagnosis of central zone prostate cancer .Methods This retrospective study included 39 patients with prostate le-sion in central zone conformed by biopsy or surgical pathology in one week after they underwent DCE MRI by using 3 .0 T whole-body MR scanner .Quantitation of the pharmacokinetic parameters of prostate lesion and non-lesion area in central zone were measured including volume transfer constant (Ktrans ) ,extravascular extracellular space distribute volume per u-nit tissue volume (Ve ) .One-way ANOVA and receiver operating characteristic curve (ROC) analysis were used to com-pare the differences of prostate cancer ,benign hyperplasia and normal tissue of non-lesion area in central zone .Results The mean Ktrans and Ve of the prostate cancer in central zone (n=17) were (13 .09 ± 2 .55) min-1 and (4 .57 ± 0 .81) ,while (8.79 ± 1 .15) min-1 and (5 .14 ± 1 .02) for benign hyperplasia (n=22) and (5 .34 ± 0 .98) min-1 and (4 .23 ± 0 .78) for nor-mal tissue of non-lesion area in central zone (n=29) ,respectively .There were significant differences between central zone prostate cancer ,benign hyperplasia and normal tissue of non-lesion area in Ktrans ( F =4 .271 ,P <0 .05) .There were no significant differences between central zone prostate cancer ,benign hyperplasia and normal tissue of non-lesion area in Ve ( F=1 .553 ,P >0 .05) .The sensitivity of Ktrans and Ve was 73 .4% and 54 .3% ,and the specificity of those was 82.7%and 47 .9% ,for differential diagnosis between prostate cancer and benign hyperplasia in central zone with the maximum Youden’ index as cut off .Conclusion Ktrans derived from 3 .0T DCE MRI is valuable in the differential diagnosis of central zone prostate cancer from benign hyperplasia while Ve is not much sence .